Service Details

CONCUSSION Management & Vestibular Physiotherapy

WHAT is a concussion?

A concussion is a clinical condition which usually results in a temporary change in brain function. Although the brain is well protected by the skull and surrounding cerebrospinal fluid, these structures are not always able to protect the brain from injury.

Any trauma that involves a direct “blow to the head” or violent shaking can override these protective structures and lead to a concussion. Essentially, the rapid movement of the brain can result in a “bang” against the skull leading to harmful changes in the brain/brain tissue thus interfering with normal brain function.

Concussion symptoms can appear immediately or have a delayed onset, however, the vast majority resolve by themselves within a short time period. Studies suggest, once a person suffers a concussion, even a mild bump on the head or a vigorous shake can further aggravate the already sensitized tissues of the brain.

IF concussion symptoms persist, known as post concussion syndrome, it can lead to serious long-term health effects and can affect quality of life. This is considered by experts as a desperate condition that needs different treatment approaches.

What are the symptoms of a concussion?

A concussion can not be identified or diagnosed with standard imaging tools like MRI and CAT scans. Instead, healthcare providers look for signs and symptoms of abnormal brain function to make a diagnosis.
Keep in mind, every person’s brain is different and every injury is different so symptoms can vary person to person.

Common symptoms include:

  • Dizziness
  • Headaches
  • Visual changes
  • Balance and walking changes
  • Motion sensitivity
  • Sleep disturbances
  • Nausea
  • Fatigue

Other symptoms after a concussion may include:

  • Memory changes and confusion
  • Mood changes
  • Slurred speech


Concussion rehabilitation is a specialty within Physiotherapy where evidenced-based treatment protocols are used to address the symptoms of a concussion and/or post concussion syndrome.

Our physiotherapists have special concussion management training to help patients with safe and optimal recovery time (optimal does not necessarily mean fast).

Your physiotherapist will perform a thorough evaluation of your neurological system including eye tracking and eye movements, musculoskeletal system, balance systems and determine tolerance for exertion. Once assessment is performed, your physiotherapist will prescribe a treatment program individualized to suit your specific needs and tailored to fit your tolerance.

Treatment techniques can include:

  • Manual therapy for neck and headache concerns
  • Education, symptom relief, desensitization therapies
  • Balance training
  • Neck rehab therapy
  • Sub-symptom cardio exercise
  • Vision rehab therapy
  • Vestibular rehab therapy
  • Cognitive rehab therapy
  • Activity reconditioning

It is very important to follow the instructions of our physiotherapists that are highly trained in the rehabilitation of concussion injuries.


What is the Vestibular System?

The body is composed of many integrated systems that allow us to move though the world with grace. One of the most critical systems we have is the vestibular system. This system, consisting of parts of the inner ear and various pathways that lead to the brain, help control balance and eye movements. If the system is damaged by disease, aging, or injury, vestibular disorders or balance difficulties can result.

What are the causes of a Vestibular dysfunction?

A common cause of dizziness and balance disorders is called Benign Paroxysmal Positional Vertigo (BPPV), a common type of vertigo. This condition directly affects the vestibular system and can easily be triggered by specific changes in the position of your head altering the position of crystals within the inner ear. When these crystals, also known as Otolith organs, become dislodged they can cause feelings of dizziness.
Others may include: Unilateral or bilateral vestibular hypofunction (reduced inner ear function on one or both sides) labyrinthitis, vestibular neuronitis, acoustic neuroma, concussions, Ménière’s disease, disuse atrophy, and neuropathy.

What are symptoms of a Vestibular dysfunction?

There are a number of symptoms associated with vestibular dysfunctions. Some of the typical symptoms include:

  • Dizziness
  •  Vertigo – world is spinning sensation
  • Lightheadedness
  • Loss of balance or unsteadiness
  • Difficulty concentrating
  • Blurry vision
  • Nausea
  • Vomiting

What is Vestibular Rehabilitation?

Vestibular Rehabilitation is a specialty within physiotherapy that uses extensively researched evidenced-based medicine.
Treatment of balance and dizziness disorders can be very complex. The most important part of treating a balance disorder is understanding your diagnosis, the cause of the problem, and how to manage it. That’s why we place great emphasis on patient education and coordination of care with your referring physician.

How we can help?

One of our qualified Physiotherapists will perform a thorough evaluation that begins with a medical history to understand the severity and frequency of your symptoms, your triggers, and the impact your symptoms have on your life.

The assessment includes evaluating your balance and gait, motion sensitivity, severity of vertigo, and the musculoskeletal system involved, to determine the source of the dizziness or balance problem.

Once assessed the treatment can include customized programs designed to promote central nervous system re-training for inner ear deficits. The primary goal is to retrain the brain to coordinate information from the inner ear balance organs, vision and the proprioceptive system (sensory receptors that are sensitive to stretch or pressure).

Treatment can involve canalith repositioning, symptom relief, gaze stability and substitution exercises, balance & gait training, habituation exercises (to overcome motion sickness and sensitivity), and exercises for you to gradually return to work, leisure and sports.

Book an appointment for the Vestibular therapy and Concussion therapy in Etobicoke.